Bacteria That Strike Elderly Spread in Canadian Hospitals

By CLIFFORD KRAUSS

Published: August 9, 2004

TORONTO, Aug. 8—
A type of bacteria that causes virulent diarrhea in the elderly has been spreading through hospitals in Quebec and Alberta and may have contributed to the deaths of 100 patients in one institution alone in the past 18 months, medical authorities said Sunday.

The spread of an infectious illness in at least a handful of hospitals has stirred the concerns among Canadian health experts that surfaced last year when more than 40 people died in and around Toronto during the SARS epidemic, mostly in hospital settings.

Hospital officials conceded then -- and still do -- that their housekeeping staffs have been stretched thin because of cutbacks in federal and provincial funding in recent years and that sanitary conditions leave much to be desired.

The bacteria are commonly found in hospitals, and does not pose a health threat to healthy people. But it can be deadly to already weakened people who are being treated with antibiotics for other illnesses that allows the bacteria to flourish in the intestinal tract.

A new analysis by the Canadian Medical Association Journal found that in two hospitals in Montreal and one in Sherbrooke, Quebec, the rate of patients contracting the bacteria, known as clostridium difficile or C. difficile, had increased from 2.1 cases per 1,000 admissions in 2002 to 10 per 1,000 in 2003 and that the upward trend had continued this year.

The study found that the bacteria have taken their heaviest toll in the University of Sherbrooke's medical center in southern Quebec, where 54 deaths in 2003 and 46 more during the first half of 2004 were linked to the bacteria. The hospital has managed to decrease the rate of illness in recent months, the report said.

The bacteria were also found to have contributed to the deaths of 81 patients in Montreal, Canada's second-largest city, in recent years, which underscored that many hospitals there are in a rundown state.

The Quebec health minister, Philippe Couillard, responded cautiously to the study. ''One hundred people died while having the bacteria in them,'' he told the Canadian Press news service. ''It doesn't mean that their deaths were due to the bacteria.''

Nevertheless, Quebec public health officials have been tracking the outbreak of cases since June and they have been urging hospitals to reinvigorate their hygiene programs. Beginning this month, more than 100 area facilities will issue monthly reports on contraction of the bacteria to provincial authorities.

Hospitals have stepped up precautions, including urging their staff members to wash their hands frequently.